肝硬化腹水患者血浆降钙素原水平的临床研究

目的观察肝硬化自发性细菌性腹膜炎(SBP)患者血浆降钙素原(PCT)的水平。方法采用半定量免疫色谱法检测30例肝硬化腹水患者[包括单纯腹水16例(非SBP组)、合并SBP者14例(SBP组)]及20名健康体检者血浆PCT和血清CRP水平。以患者第1次测定值作为基线值。结果 SBP组血浆PCT和血清CRP水平在SBP发生后3、6、12 h均明显高于基线值(P<0.01),并明显高于非SBP组及对照组(P<0.01)。治疗后SBP组和非SBP组中存活的患者血浆PCT水平分别为0.48±0.25和(0.49±0.14)ng/mL,二者比较差异无统计学意义(P>0.05),且均低于基线值(P<0.01)。死亡患者的血浆PCT水平治疗后反而继续升高,SBP组[4例,(37.67±15.48)ng/mL]明显高于非SBP组[4例,(14.75±7.89)ng/mL]。结论血浆PCT水平检测有助于诊断肝硬化腹水患者SBP的发生,若持续升高可能提示有细菌感染和预后不良。

Clinical study on the level of plasma procalcitonin in patients with hepatic cirrhosis and ascites

Objective To observe the level of plasma procalcitonin(PCT) in patients with hepatic cirrhosis and spontaneous bacterial peritonitis(SBP).Methods A total of 30 patients with hepatic cirrhosis and ascites were enrolled,including 16 patients without SBP(the non-SBP group) and 14 patients with SBP(the SBP group),and 20 healthy subjects were enrolled as controls.The levels of plasma PCT and serum C reative protein(CRP) were measured by semi-quantitative immunochromatographic test.The levels at the first time determination were as baseline values.Results The levels of plasma PCT and serum CRP significantly increased in SBP group 3h,6h,12h after SBP occured when compared with the baseline values(P<0.01),and were significantly higher than those in the non-SBP group and controls(P<0.01).After treatment,the levels of plasma PCT in the survivals were(0.48±0.25) ng/mL in the SBP group and(0.49±0.14) ng/mL in the non-SBP group,and no statistical significance was found(P>0.05).They were significantly lower than the baseline values(P<0.01).The levels of plasma PCT in the dying patients kept on a high level after treatment,and that in the SBP group [4 cases,(37.67±15.48) ng/mL] was significantly higher than that in the non-SBP group [4 cases,(14.75±7.89) ng/mL].Conclusions The level of plasma PCT is useful for the diagnosis of SBP in patients with hepatic cirrhosis and ascites.If keeping on a high level,it may indicate bacterial infection and a bad prognosis.